Objective:To investigate the prevalence of adult skeletal fluorosis caused by drinking tea-type endemic fluorosis in Yushu Tibetan Autonomous Prefecture (hereinafter referred to as Yushu Prefecture), Qinghai Province, and provide scientific basis for prevention and control of the disease.Methods:In August 2021, one village was selected as a survey site in six counties (cities) in Yushu Prefecture, including Nangqian, Chindu, Yushu, Zadoi, Qumarlêb, and Zhiduo. Drinking water samples and 10 brick tea samples were collected from each village to determine the fluoride content in water and brick tea; at least 100 permanent residents aged ≥ 25, who had a habit of drinking brick tea and had lived in the local area for more than 5 years, were selected for X-ray imaging to examine the prevalence of adult skeletal fluorosis.Results:A total of 75 samples of residential drinking water were collected, with a fluoride content of (0.21 ± 0.05) mg/L, ranging from 0.11 to 0.34 mg/L; 60 samples of brick tea, with a fluoride content of (626.70 ± 157.27) mg/kg, ranging from 324.00 to 2 102.00 mg/kg. A total of 1 136 adults were examined, and 318 cases of skeletal fluorosis were diagnosed, with a detection rate of 27.99%. Among them, the detection rates of mild, moderate, and severe skeletal fluorosis were 20.95% (238/1 136), 6.07% (69/1 136), and 0.97% (11/1 136), respectively, with mild symptoms being the main. The detection rates of skeletal fluorosis in males and females were 29.09% (121/416) and 27.36% (197/720), respectively, with no statistically significant difference between the gender (χ 2 = 0.39, P = 0.533). Comparison of the skeletal fluorosis in different gender, the differences were statistically significant (χ 2 = 22.31, P < 0.001). The detection rates of skeletal fluorosis in the age groups of 25 - 35, 36 - 45, 46 - 55, 56 - 65, 66 - 75, and ≥76 years old were 6.86% (7/102), 22.37% (51/228), 24.02% (92/383), 37.44% (73/195), 43.48% (70/161), and 37.31% (25/67), respectively. The differences between the groups were statistically significant (χ 2 = 59.84, P < 0.001). Moreover, there was a statistically significant difference in the composition of skeletal fluorosis among different age groups ( H = 37.66, P < 0.001). The Spearman correlation analysis results showed that the severity of adult skeletal fluorosis was positively correlated with age ( r = 0.34, P < 0.001). Conclusions:There is a certain degree of prevalence of adult skeletal fluorosis in Yushu Prefecture. And as age increases, the condition of skeletal fluorosis becomes more severe.

Objective To investigate the clinical efficacy of Liuwei Anshen Capsules combined with Amlodipine+Benazepril Tablets in the treatment of senile essential hypertension(EH)patients complicated with anxiety and depressive disorders and its intervention effect on the expression of N-methyl-D-aspartate receptor 2B subunit(NR2B)protein.Methods A retrospective study was conducted on 138 senile EH patients complicated with anxiety and depressive disorders of accumulation of excess phlegm-heat syndrome treated in the Geriatric Department of Sinopharm Gezhouba Central Hospital from December 2020 to December 2022.The patients were divided into an observation group and a control group according to the treatment schemes,with 69 cases in each group.The control group was treated with Amlodipine+Benazepril Tablets and routine psychotherapy,and the observation group was treated with Liuwei Anshen Capsules orally on the basis of treatment for the control group.The course of treatment lasted for one month.The changes of blood pressure indicators of systolic blood pressure(SBP)and diastolic blood pressure(DBP),Hamilton Anxiety Scale(HAMA)score,17-Item Hamilton Depression Scale(HAMD-17)score,NR2B protein expression,and the levels of monoamine neurotransmitters of dopamine(DA),epinephrine(NE),and 5-hydroxytryptamine(5-HT)in the two groups were observed before and after treatment.After treatment,the clinical efficacy and total incidence of adverse reactions were compared between the two groups.Results(1)After one month of treatment,the total effective rate of the observation group was 95.65%(66/69),and that of the control group was 75.36%(52/69).The intergroup comparison(tested by chi-square test)showed that the curative effect of the observation group was significantly superior to that of the control group(P＜0.01).(2)After treatment,the SBP and DBP of the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of SBP and DBP in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the HAMA score and HAMD-17 score of the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of HAMA score and HAMD-17 score in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the expression level of NR2B protein in the two groups was significantly decreased compared with that before treatment(P＜0.05),and the decrease in the observation group was superior to that in the control group(P＜0.01).(5)After treatment,the levels of serum DA,NE and 5-HT in the two groups were significantly decreased in comparison with those before treatment(P＜0.05),and the decrease of serum DA,NE and 5-HT levels in the observation group was significantly superior to that in the control group(P＜0.01).(6)The total incidence of adverse reactions in the observation group was 2.90%(2/69)and that in the control group was 5.80%(4/69).There was no significant difference between the two groups(P＞0.05).Conclusion Liuwei Anshen Capsules combined with Amlodipine+Benazepril Tablets can effectively alleviate the bad mood,decrease blood pressure,inhibit the overexpression of NR2B protein,and correct the disorder of monoamine neurotransmitters in senile EH patients complicated with anxiety and depressive disorders of accumulation of excess phlegm-heat syndrome.The combined treatment does not cause serious adverse reactions,which is safe and effective.

Objective:To investigate the psychological status of the outpatients in the andrology clinic and the effect of risk warning combined with multidisciplinary team(MDT)intervention on their satisfaction.Methods:Using convenience sampling,we enrolled 600 outpatients seeking medical attention in the Department of Andrology of our hospital from July to October 2022.We ran-domized the patients into a control(n=300)and an observation group(n=300),obtained their basic information,evaluated their psychological status with the Hospital Anxiety and Depression Scale(HADS),and assessed their satisfaction with the Xijing Hospital Outpatients'Satisfaction Questionnaire(HOSQ).The controls followed the routine procedure of treatment,while the patients in the ob-servation group received early warning before intervention based on their HADS scores.We provided normal medical care for those with HADS scores≤7,employed empathetic communication for those with HADS scores of 8-10,and conducted MDT intervention for those with HADS scores≥1l,followed by comparison of the patients'satisfaction with the outpatient service between the two groups.Results:There were no statistically significant differences in general conditions between the groups of patients(P＞0.05).The mean prevalence rate of anxiety and depression was 47.83％among the male subjects,lower in the control than in the observation group(47.00％vs 48.67％,P＞0.05),but higher in the patients with the education of junior high school or below(60.99％)than in those with that of senior high school(22.34％)and university or above(16.67％),and also higher in those aged 18-40 years(67.38％)than in those aged 41-60 years(51.82％)and over 60 years old(38.33％).A significantly higher rate of satisfaction with the outpatient service was found in the observation group than in the controls(97.18％vs 90.39％,P＜0.05).Conclusion:Anxie-ty and depression are prevalent among the outpatients in the andrology clinic,with a higher prevalence rate in those with lower educa-tion and at a younger age.Early risk warning combined with MDT intervention can improve the satisfaction of the patients.

The world has paid a heavy price for the pandemic of the emerging respiratory communicable disease, so more concern about communicable disease surveillance and early warning has been aroused. This paper briefly reviews the establishment of the surveillance and early warning system of respiratory communicable diseases in China, discusses its future development and introduces the novel surveillance methods and early warning models for the purpose of establishment of a multi-channel surveillance and multi-dimensional early warning system of communicable diseases in the future and the improvement of the prevention and control of emerging respiratory communicable diseases in China.
Humans ; Population Surveillance/methods* ; Communicable Diseases/epidemiology* ; Communicable Diseases, Emerging/prevention & control* ; China/epidemiology* ; Pandemics ; Disease Outbreaks/prevention & control*

Objective: To investigate the response characteristics of patients with locally advanced/metastatic non-squamous non-small cell lung cancer (nsq-NSCLC) treated with tislelizumab in combination with chemotherapy in the first line. Methods: Patients with nsq-NSCLC who achieved complete or partial remission after treatment with tislelizumab in combination with chemotherapy or chemotherapy alone in the RATIONALE 304 study, as assessed by an independent review board, were selected to analyze the response characteristics and safety profile of the responders. Time to response (TTR) was defined as the time from randomization to the achievement of first objective response. Depth of response (DpR) was defined as the maximum percentage of tumor shrinkage compared with the sum of the baseline target lesion length diameters. Results: As of January 23, 2020, 128 patients treated with tislelizumab in combination with chemotherapy achieved objective tumor response (responders), representing 57.4%(128/223) of the intention-to-treat population, with a TTR of 5.1 to 33.3 weeks and a median TTR of 7.9 weeks. Of the responders (128), 50.8%(65) achieved first remission at the first efficacy assessment (week 6), 31.3%(40) at the second efficacy assessment (week 12), and 18.0%(23) at the third and subsequent tumor assessments. The percentages of responders who achieved a depth of tumor response of 30% to <50%, 50% to <70% and 70% to 100% were 45.3%(58/128), 28.1%(36/128) and 26.6%(34/128), respectively, with median progression-free survival (PFS) of 9.0 months (95% CI: 7.7 to 9.9 months), 11.5 months (95% CI: 7.7 months to not reached) and not reached (95% CI: 11.8 months to not estimable), respectively. Tislelizumab plus chemotherapy were generally well tolerated in responders with similar safety profile to the overall safety population. Conclusion: Among responders to tislelizumab in combination with chemotherapy for nsq-NSCLC, 82.0%(105/128) achieves response within the first two tumor assessments (12 weeks) and 18.0%(23/128) achieves response at later (18 to 33 weeks) assessments, and there is a trend toward prolonged PFS in responders with deeper tumor response.
Humans ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Lung Neoplasms/pathology* ; Treatment Outcome

With the outbreak of infectious diseases, more and more attention has been paid to surveillance and early warning work. Timely and accurate monitoring data is the basis of infectious diseases prevention and control. Effective early warning methods for infectious diseases can improve the timeliness and sensitivity of early warning work. This paper briefly introduces the intelligent early warning model of infectious diseases, summarizes the emerging surveillance and early warning methods of infectious diseases, and seeks the possibility of diversified surveillance and early warning in different epidemic stages and different outbreak scenarios of infectious diseases. This paper puts forward the idea of constructing a diversified method system of infectious diseases surveillance and early warning based on multi-stages and multi-scenarios and discusses the future development trend of infectious diseases surveillance and early warning, in order to provide reference for improving the construction level of infectious diseases surveillance and early warning system in China.
Humans ; Population Surveillance/methods* ; Communicable Diseases/epidemiology* ; Disease Outbreaks/prevention & control* ; Epidemics ; China/epidemiology*

With the outbreak of infectious diseases, more and more attention has been paid to surveillance and early warning work. Timely and accurate monitoring data is the basis of infectious diseases prevention and control. Effective early warning methods for infectious diseases can improve the timeliness and sensitivity of early warning work. This paper briefly introduces the intelligent early warning model of infectious diseases, summarizes the emerging surveillance and early warning methods of infectious diseases, and seeks the possibility of diversified surveillance and early warning in different epidemic stages and different outbreak scenarios of infectious diseases. This paper puts forward the idea of constructing a diversified method system of infectious diseases surveillance and early warning based on multi-stages and multi-scenarios and discusses the future development trend of infectious diseases surveillance and early warning, in order to provide reference for improving the construction level of infectious diseases surveillance and early warning system in China.
Humans ; Population Surveillance/methods* ; Communicable Diseases/epidemiology* ; Disease Outbreaks/prevention & control* ; Epidemics ; China/epidemiology*

Objective:To investigate the influencing factors for endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events in novice trainees and establishment of its prediction model.Methods:The prospective study was conducted. The clinical data of 12 novice trainees of ERCP in the First Hospital of Lanzhou University from July 2016 to July 2019 were selected. The operation was performed by 12 novice trainees of ERCP under the guidance of the endoscopic experts. Observation indicators: (1) ERCP-related adverse events in novice trainees; (2) analysis of influencing factors for ERCP-related adverse events in novice trainees; (3) establishment of a prediction model for ERCP-related adverse events in novice trainees. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were represented as M(range), and com-parison between groups was analyzed by the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test. The Logistic regression model was used for univariate and multivariate analyses. The regression coefficients were used to construct a prediction model. The receiver operating characteristic curve was drawn, and the area under curve was used to evaluate the predictive ability. Results:(1) ERCP-related adverse events in novice trainees. Of the 300 patients with ERCP operated by 12 novice trainees, 52 cases had ERCP-related adverse events and 248 cases had no ERCP-related adverse events. Cases in grade 1?2 or grade 3?4 of ERCP difficulty classification, score for intubation time, score for cannulation time, cases with or without completion of the cannulation, cases with or with-out basket stone removal, cases with or without stenosis expansion, score for contrast-enhanced interpretation, score for implementation of reasonable treatment and score for expected purpose reached were 22, 30, 8(range, 5?10), 20(rang, 9?20), 24, 28, 11, 41, 0, 52, 39±17, 39±19 and 44±23 for novice trainees with ERCP-related adverse events, versus 146, 102, 6(range, 4?9), 12(range, 8?20), 163, 85, 94, 154, 20, 228, 52±22, 80±20, 52±23 for novice trainees without ERCP-related adverse events, showing significant differences in the above indicators between them ( χ2=4.79, Z=?2.46, ?2.72, χ2=7.01, 5.30, 4.49, t=?4.00, ?2.97, ?2.29, P<0.05). (2) Analysis of influencing factors for ERCP-related adverse events in novice trainees. Results of univariate analysis showed that the diffi-culty classification of ERCP, intubation time, cannulation time, completion of cannulation, basket stone extraction, contrast-enhanced interpretation, implementation of reasonable treatment and expected purpose reached were related factors for ERCP-related adverse events in novice trainees ( odds ratio=1.95, 1.11, 1.08, 0.45, 0.44, 0.97, 0.98, 0.98, 95% confidence intervals as 1.07?3.58, 1.02?1.22, 1.02?1.14, 0.24?0.82, 0.22?0.90, 0.96?0.99, 0.96?0.99, 0.97?1.00, P<0.05). Results of multi-variate analysis showed that difficulty classification of ERCP and contrast-enhanced interpretation were independent influencing factors for ERCP-related adverse events in novice trainees ( odds ratio=2.08, 0.95, 95% confidence intervals as 1.10?3.96, 0.92?0.99, P<0.05). (3) Establishment of a predic-tion model for ERCP-related adverse events in novice trainees. According to the important outcome indicators of clinical training and results of multivariate analysis, 4 indicators including difficulty classification of ERCP, intubation time, cannulation time and contrast-enhanced interpretation were included to establish a prediction model for ERCP-related adverse events in novice trainees, which indicated that trainees with the predicted score >0.4 were in high risk of ERCP-related adverse events. The area under receiver operating characteristic curve of the prediction model was 0.72(95% confidence interval as 0.65?0.79, P<0.05), with the best cut-off value as 0.40, the sensitivity as 76.9% and the specificity as 63.3%. Conclusion:The difficulty classification of ERCP and contrast-enhanced interpretation are independent influencing factors for ERCP-related adverse events in novice trainees. Novice trainees with a predicted score >0.4 are high-risk groups of ERCP-related adverse events.

Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme 2 ; Betacoronavirus ; COVID-19 ; Cardiovascular Agents/pharmacology* ; Cardiovascular Diseases ; Coronavirus Infections/physiopathology* ; Humans ; Pandemics ; Peptidyl-Dipeptidase A/physiology* ; Pneumonia, Viral/physiopathology* ; SARS-CoV-2

Viral infections cause at least 10%-15% of all human carcinomas. Over the last century, the elucidation of viral oncogenic roles in many cancer types has provided fundamental knowledge on carcinogenetic mechanisms and established a basis for the early intervention of virus-related cancers. Meanwhile, rapidly evolving genome-editing techniques targeting viral DNA/RNA have emerged as novel therapeutic strategies for treating virus-related carcinogenesis and have begun showing promising results. This review discusses the recent advances of genome-editing tools for treating tumorigenic viruses and their corresponding cancers, the challenges that must be overcome before clinically applying such genome-editing technologies, and more importantly, the potential solutions to these challenges.
Antiviral Agents ; therapeutic use ; CRISPR-Cas Systems ; Carcinoma ; genetics ; therapy ; virology ; Gene Editing ; Genetic Predisposition to Disease ; Genetic Therapy ; methods ; Humans ; Tumor Virus Infections ; complications